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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(03): 426-434
DOI: 10.1055/s-0044-1787868
Original Article

How Flow Diverter Selection Can Affect the Flow Changes within a Jailed Ophthalmic Artery: A Computational Fluid Dynamics Study

Can Ünsal
1   Numerical Simulation and Spray Targeting Division, Department of Engineering, Bosch, Bursa, Türkiye
,
Görkem Güçlü
2   Department of Mechanical Engineering, Southern Methodist University, Dallas, Texas, United States
,
Ali Bahadir Olcay
3   Department of Mechanical Engineering, Faculty of Engineering, Yeditepe University, Istanbul, Türkiye
,
Amir Hassankhani
4   Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
,
Cem Bilgin
5   Department of Radiology, Mayo Clinic, Rochester, Minnesota, United States
,
Bahattin Hakyemez
6   Department of Radiology, Uludag University School of Medicine, Bursa, Türkiye
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Abstract

Introduction Flow diverter (FD) stents are widely used to treat giant aneurysms by reducing blood flow into the aneurysm sac. However, choosing the optimal FD for a patient can be challenging when a nearby artery, such as the ophthalmic artery (OA), is jailed by the FD placement. This study compares the impact of two FD stents with different effective metal surface area (EMSA) values on OA occlusion.

Materials and Methods A numerical model of a 59-year-old female patient with a giant aneurysm in the left internal carotid artery and a jailed OA was created based on clinical data. Two FD stents, FRED4017 and FRED4518, with different EMSA values at the aneurysm neck and OA inlet, were virtually deployed in the model. Blood flow and occlusion amount in the OA were simulated and compared between the two FD stents.

Results FRED4017 had higher EMSA values than FRED4518 at the aneurysm neck (35% vs. 24.6%) and lower EMSA values at the OA inlet (15% vs. 21.2%). FRED4017 caused more occlusion in the OA than FRED4518 (40% vs. 28%), indicating a higher risk of ocular ischemic syndrome.

Conclusion The EMSA value of FD stents affects the blood flow and occlusion amount in the jailed OA. Therefore, selecting an FD stent with a low EMSA value at the OA inlet may be beneficial for patients with a nearby jailed artery at the aneurysm neck.

Keywords

cerebral aneurysm - jailed artery - ocular ischemic syndrome - flow diverter stent - patient-specific CFD modeling


Publication History

Article published online:
27 June 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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